Some Contributions of Functional Analysis to the Assessment of Behaviors Associated with Attention Deficit Hyperactivity Disorder and the Effects of Stimulant Medication

By Northup, John; Gulley, Veronica | School Psychology Review, Spring 2001 | Go to article overview

Some Contributions of Functional Analysis to the Assessment of Behaviors Associated with Attention Deficit Hyperactivity Disorder and the Effects of Stimulant Medication


Northup, John, Gulley, Veronica, School Psychology Review


Abstract. The usefulness of functional analysis procedures for the assessment and treatment of behaviors associated with Attention Deficit Hyperactivity Disorder has been the subject of a number of recent investigations. This article provides a selected review of recent studies and examines potential implications for practice. Conclusions suggest that functional analysis may be particularly useful for identifying behaviors that are (or are not) maintained by social consequences and for the subsequent development of optimal individualized treatments. A review of recent studies in which the researchers have conducted functional analyses while also conducting concurrent medication assessments is also provided. Conclusions illustrate the unique contributions of functional analysis procedures to medication assessments. Subsequent implications for determining the most beneficial uses of medication are discussed. In conclusion, the procedures of a local public-school-based program are described to illustrate the pot ential for classroom-based applications of general functional assessment procedures to evaluate the effects of behavioral and medication treatments.

The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and the use of stimulant medications has increased progressively and dramatically over recent years (Pincus et al., 1998; Safer, Zito, & Fine, 1996). There is also an increasing trend to diagnose ADHD (those most likely to receive medication) at earlier ages and to prescribe medication(s) at earlier ages (Zito et al., 2000). Unfortunately, there are no tests, no procedures, and few if any markers that are useful for the prediction of stimulant medication effects prior to administration of the medication. Currently, only individualized school-based assessments can best answer the many questions regarding the most appropriate use, if any, of stimulant medication.

The purpose of this article is to evaluate the potential benefits functional analysis can contribute to the assessment of behaviors commonly associated with ADHD as well as to the assessment of stimulant medication effects and alternative behavioral treatments. The systematic use of functional analysis and functional assessment procedures may provide objective, data-based methods for answering many of the most important questions related to the use of stimulant medication in the classroom. In conclusion, the procedures currently in use at a local school are described as one illustration of the use of general functional assessment procedures to conduct routine assessments of the effects of behavioral and medication treatments in a school setting.

Functional Analysis and Assessment for Children with a Diagnosis of ADHD

The potential importance of conducting a functional analysis or a functional assessment for the purpose of developing behavioral treatments for children with a diagnosis of ADHD and similar behavior problems has been increasingly recognized in recent years (e.g., DuPaul, Eckert, & McGoey, 1997). Functional assessment typically refers to a range of general assessment methods (e.g., questionnaires, rating scales) used to describe and formulate hypotheses regarding variables that may control behavior. Functional analysis' typically refers to the experimental manipulation of environmental variables that commonly maintain Problem behaviors, or to test or verify a hypothesis of maintaining variables (Horner, 1.994). The results of experimental functional analysis procedures may also contribute to the further development and refinement of more general functional assessment procedures. The use of functional analysis procedures to assess behaviors commonly associated with ADHD is the primary emphasis of this selected review.

The goal of functional analysis and functional assessment is to better understand the maintaining contingencies of problem behavior (i.e., why a behavior occurs). One applied implication is that treatment, and especially reinforcement-based treatment, can be matched to the results of the functional analysis on an individual basis. …

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